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==Classification==
==Classification==
There is no established system for the classification of primary biliary cirrhosis. However, it can be classified into four stages according to histological classification of Ludwig. According to Ludwig classification, all four stages may be present on a single liver biopsy.<ref name="pmid19554543">{{cite journal| author=Lindor KD, Gershwin ME, Poupon R, Kaplan M, Bergasa NV, Heathcote EJ et al.| title=Primary biliary cirrhosis. | journal=Hepatology | year= 2009 | volume= 50 | issue= 1 | pages= 291-308 | pmid=19554543 | doi=10.1002/hep.22906 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19554543  }} </ref><ref name="pmid150690">{{cite journal| author=Ludwig J, Dickson ER, McDonald GS| title=Staging of chronic nonsuppurative destructive cholangitis (syndrome of primary biliary cirrhosis). | journal=Virchows Arch A Pathol Anat Histol | year= 1978 | volume= 379 | issue= 2 | pages= 103-12 | pmid=150690 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=150690  }} </ref>
* There is no established system for the classification of primary biliary cirrhosis.
===Stage 0===
* However, it can be classified into four stages according to histological classification of Ludwig. According to Ludwig classification, all four stages may be present on a single liver biopsy.<ref name="pmid19554543">{{cite journal| author=Lindor KD, Gershwin ME, Poupon R, Kaplan M, Bergasa NV, Heathcote EJ et al.| title=Primary biliary cirrhosis. | journal=Hepatology | year= 2009 | volume= 50 | issue= 1 | pages= 291-308 | pmid=19554543 | doi=10.1002/hep.22906 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19554543  }} </ref><ref name="pmid150690">{{cite journal| author=Ludwig J, Dickson ER, McDonald GS| title=Staging of chronic nonsuppurative destructive cholangitis (syndrome of primary biliary cirrhosis). | journal=Virchows Arch A Pathol Anat Histol | year= 1978 | volume= 379 | issue= 2 | pages= 103-12 | pmid=150690 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=150690  }} </ref>
*Normal liver
* It can also be classified into four stages according to the histological classification of P. Scheuer.<ref name="pmid6066569">{{cite journal| author=Scheuer P| title=Primary biliary cirrhosis. | journal=Proc R Soc Med | year= 1967 | volume= 60 | issue= 12 | pages= 1257-60 | pmid=6066569 | doi= | pmc=1901478 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=6066569  }}</ref>


===Stage 1===
*Stage 1 is characterized by portal inflammation.


===Stage 2===
{|
*Extension of inflammation beyond portal tracts into surrounding parenchyma with or without ductal loss.
! Classification of Primary biliary cirrhosis on the basis of histology
|-
!Ludwig classification
|-
|Stage
|Histologic
|-
|Stage 0
|Normal liver
|-
|Stage 1
|Stage 1 is characterized by portal inflammation
|-
|Stage 2
|Extension of inflammation beyond portal tracts into surrounding parenchyma with or without ductal loss
|-
|Stage 3
|There is presence of fibrous septa linking adjacent portal tracts
|-
|Stage 4
|Stage 4 is characterized by cirrhosis
|-
!Scheuer's classification
|-
|Stage 1
|florid duct lesion or chronic non-suppurative destructive cholangitis
|-
|Stage 2
| proliferation of the small bile ductules
|-
|Stage 3
| fibrosis or scarring
|-
|Stage 4
| cirrhosis
|}


===Stage 3===  
======
*There is presence of fibrous septa linking adjacent portal tracts.
*


===Stage 4===
======
*Stage 4 is characterized by cirrhosis.
*.
 
======
*.
 
======
*.
 
======
*.


==References==
==References==

Revision as of 20:26, 5 February 2018

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Aysha Anwar, M.B.B.S[2]

Overview

There is no established system for the classification of Primary biliary cirrhosis. However, it can be classified into four stages depending on the histology of the disease.[1]

Classification

  • There is no established system for the classification of primary biliary cirrhosis.
  • However, it can be classified into four stages according to histological classification of Ludwig. According to Ludwig classification, all four stages may be present on a single liver biopsy.[1][2]
  • It can also be classified into four stages according to the histological classification of P. Scheuer.[3]


Classification of Primary biliary cirrhosis on the basis of histology
Ludwig classification
Stage Histologic
Stage 0 Normal liver
Stage 1 Stage 1 is characterized by portal inflammation
Stage 2 Extension of inflammation beyond portal tracts into surrounding parenchyma with or without ductal loss
Stage 3 There is presence of fibrous septa linking adjacent portal tracts
Stage 4 Stage 4 is characterized by cirrhosis
Scheuer's classification
Stage 1 florid duct lesion or chronic non-suppurative destructive cholangitis
Stage 2 proliferation of the small bile ductules
Stage 3 fibrosis or scarring
Stage 4 cirrhosis

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References

  1. ↑ 1.0 1.1 Lindor KD, Gershwin ME, Poupon R, Kaplan M, Bergasa NV, Heathcote EJ; et al. (2009). "Primary biliary cirrhosis". Hepatology. 50 (1): 291–308. doi:10.1002/hep.22906. PMID 19554543.
  2. ↑ Ludwig J, Dickson ER, McDonald GS (1978). "Staging of chronic nonsuppurative destructive cholangitis (syndrome of primary biliary cirrhosis)". Virchows Arch A Pathol Anat Histol. 379 (2): 103–12. PMID 150690.
  3. ↑ Scheuer P (1967). "Primary biliary cirrhosis". Proc R Soc Med. 60 (12): 1257–60. PMC 1901478. PMID 6066569.

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